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General NPI Number Information
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NPI Number | 1306959028
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Entity Type | Organization
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Legal Business Name | HAYNES AMBULANCE OF WETUMPKA
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 219 COMPANY ST
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City | WETUMPKA
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State | AL
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Zip | 36092-2758
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Country | US
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Telephone | 334-567-7039
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 116
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City | WETUMPKA
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State | AL
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Zip | 36092
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Country | US
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Telephone | 334-567-7039
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. BRANDEE HAYNES BARRETT
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Credential | EMT-P
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Telephone | 334-241-5224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0265
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License Number State | AL
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